Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
A Word from Dr. Shafi
P B F
1 Dez, 2023
It seems like at the end of every year we look back and say “Wow, what a year!"…and 2023 is no excep...
P B F
1 Nov, 2023
Colorectal Cancer Awareness Month is observed every March. But awareness of this disease – which is ...
P B F
1 Out, 2023
September is Suicide Prevention Awareness Month, and May is Mental Health Awareness Month. However, ...
BCBSRI Update
P
1 Dez, 2023
Any admin user in Health Trio (person who originally set up the HT account) has the ability to creat...
P B
1 Dez, 2023
BCBSRI is actively pursuing National Committee for Quality Assurance (NCQA) Health Equity Accreditat...
P F
1 Dez, 2023
Currently, BCBSRI utilizes eviCore for High-End Radiology and Cardiology prior authorizations and Sp...
Provider Relations
P B F
1 Dez, 2023
BCBSRI invites providers to join us on Tuesday, 12 de dezembro, 2023 from 11-12 p.m. for a conference c...
P B F
1 Dez, 2023
Effective 1 de janeiro, 2024, all existing and new Blue RI for Duals (D-SNP) members will receive new I...
P B F
1 Dez, 2023
CMS requires participating providers to complete an annual D-SNP, or dual special needs plan, Model ...
Physician & Provider Call Center
P B F
1 Jul, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
1 Jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check member benef...
Quality
P
1 Dez, 2023
Beginning in 20 de outubro23, providers who participate in our PCP Quality Incentive Program (PQIP) beg...
P
1 Nov, 2023
One of our medical record requesting vendors has changed their names. You may have seen requests for...
P
1 Nov, 2023
Beginning in October, providers who participate in our PCP Quality Incentive Program (PQIP) began se...
Behavioral Health
B
1 Dez, 2023
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
B
1 Dez, 2023
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
B
1 Dez, 2023
Per EOHHS, effective immediately, providers can directly bill Medicaid fee for service for SUD resi...
Farmácia
P F
1 Mar, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P F
6 Fev, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P B F
1 Jan, 2023
The Inflation Reduction Act (IRA) will take effect on 1 de janeiro, 2023.The Act includes the following...
Products & Benefits
P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Reivindicações
P B F
1 Nov, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
P B
1 Nov, 2023
If a group submits a claim with the incorrect rendering provider, and needs to correct it, they will...
P B
1 Abr, 2023
As a reminder, when filling out a CMS-1500 form and submitting it to BCBSRI for claims processing, i...
Policies
P F
1 Dez, 2023
Artificial Pancreas Device System Effective 1 de fevereiro, 2024, we have updated the medically nece...
P B F
1 Dez, 2023
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P B F
1 Dez, 2023
BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...